Hepatitis B, Acute

B16.0-2/B16.9

GENERAL MEASURES

Bed-rest until acute phase is over.
Avoid alcohol during the illness and for ≥ 6 months after clinical recovery.
Screen sexual contacts of patients with acute hepatitis B.
If they are non-immune (negative for hepatitis B antibodies) then they should receive hepatitis B active immunisation.

MEDICINE TREATMENT

For nausea and vomiting: (R11)

  • Metoclopramide, IV/oral, 10 mg 8 hourly as required.

Hepatitis B virus: prophylaxis following exposure e.g. needle stick injury

S61.0 + (W46.22+Z20.5+Z29.8)

Persons at risk can be protected by passive immunisation with hyper immune serum globulin prepared from blood containing anti-HBs.
It is essential that all categories of healthcare workers (HCW) who are at risk of exposure, including cleaning staff, be fully vaccinated against hepatitis B.
All exposure incidents must be adequately documented for possible subsequent compensation.
Recommended post-exposure management for HCW exposed to infectious material from patients with infectious hepatitis B (either surface antigen or e antigen positive).

Vaccination status
and antibody
response status
of HCW 		Source patient
status & treatment
HBsAg positive HBsAg negative HBsAg unknown
Unvaccinated
OR
vaccination
incomplete
  • HBIG, IM, 500
    units*

  • Hep B vaccine
    (3 doses at
    monthly intervals)
    		•
  • Initiate Hep B
    vaccination
    (month 0, 1 and 6)
    		•
  • HBIG, IM, 500
    units*
  • Hep B vaccine
    (3 doses at
    monthly intervals)
    		•
    Vaccinated
    AND
    HBsAb
    > 10 units/mL**     		No treatment No treatment No treatment
    Vaccinated
    AND
    HBsAb
    < 10 units/mL
  • HBIG, IM,
    500 units *

  • Repeat Hep B
    vaccine
    (3 doses at
    monthly intervals)
    		•
  • Initiate Hep B
    vaccination
    (month 0, 1 and 6)
    		•
  • HBIG, IM,
    500 units*

  • Repeat Hep B vaccine
    (3 doses at
    monthly intervals)
    		•

    *HBIG and first dose of vaccine to be given simultaneously, but at different sites.
    **If the delay in obtaining HBsAb results is more than 24 hours initiate treatment as for vaccinated AND HBsAb < 10 units/mL.